Esophageal inflammation disorders are gaining increased recognition in both adults and children. One example is eosinophilic esophagitis (EoE), which is an emerging, and fast-growing disorder and can be characterized by high levels of eosinophils in the esophagus, and/or basal zone hyperplasia. Diagnosis of EoE is often made based on the finding of 15 to 20 or more to 24 or more eosinophils per high power field (eos/hpf) within esophageal mucosal biopsies taken at various heights in the esophagus.
In parallel with other atopic disorders, the incidence of EoE appears to be increasing. Symptoms of EoE include, for example, abdominal pain, chest pain, choking, difficulty swallowing, failure to thrive, nausea, reflux not relieved by standard anti-flux therapy, skin rash or hives, vomiting, and weight loss. In one series, 15% of EoE patients had concurrent developmental delay.
Although EoE is becoming more frequently diagnosed throughout the world many aspects of the disease remain unclear including its etiology, natural history and optimal therapy. For example, the overlap of gastroesophageal reflux disease (GERD) and EoE symptoms is common The common occurrence regarding misdiagnosis of EoE for GERD often results in delayed treatment for patients with EoE. One symptom that does not overlap is dysphagia. Elevated levels of eosinophils can lead to esophageal fibrosis resulting in loss of esophageal function potentially leading to dysphagia, or difficulty swallowing.